NPI 1013618065

Michael Bryan Stack

Practitioner Behavior Analyst Jackson, MS

Practice location

Address: 1513 Lakeland Dr, Jackson, MS 39216-4829
Phone: (769) 777-1000
Mailing address: 1606 Laurel St, Jackson, MS 39202-1243

Registered specialties (2)

Behavior Analyst Primary

Behavioral Health & Social Service Providers Taxonomy 103K00000X Licence 1-25-85361 (MS)

Other Behavior Analyst providers in Mississippi →

Behavior Technician

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence RBT-22-226002 (MS)

Other Behavior Technician providers in Mississippi →

Registry record

NPI: 1013618065
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Mar 2023
Record last updated: 6 Jan 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.